A growing number of dentists are reconsidering PPO participation as costs rise and reimbursement falls. In this episode, Kirk Behrendt sits down with dental consultant Deborah Engelhart Nash to unpack why a reported 29% of surveyed dental practices stopped taking insurance in 2025, what fears keep dentists stuck, and how to transition the right way.

You’ll learn how to evaluate your patient mix, identify low-hanging fruit plans to drop first, communicate changes without blaming insurance, and redesign systems so your team can focus on people work instead of paperwork—listen to Episode 1016 of The Best Practices Show!

Main Takeaways

1. A survey of dental marketers’ client data reported that 29% of participating practices stopped taking insurance in 2025.
2. Leaving insurance rarely fails when doctors do due diligence on patient concentration, capacity, and fee schedules before making changes.
3. Doctors should prioritize dropping low-reimbursement plans and plans with low patient volume instead of quitting all plans at once.
4. If a practice is booked out for months with in-network patients while losing money on those visits, reducing PPO participation can open capacity for higher-fee care.
5. Successful transitions require team alignment, consistent messaging, and avoiding language that blames insurers or frames the decision as “about the money.”
6. Practices should reframe insurance as an employer-provided allowance that helps offset care rather than something that determines the standard of care.
7. Outsourcing insurance and billing work can help teams focus on patients, keep up with code changes, and improve claim outcomes.

Snippets:

00:00 Intro

02:20 The survey source and the 29% statistic from 2025.

03:15 Why some in-network hygiene visits can lose money.

05:20 The “40% cut” example to explain PPO economics to teams.

06:25 Why dentists don’t go back once they leave insurance.

07:10 The Anchorage example: when a single employer dominates the patient base.

08:10 If you’re booked out for months, cutting low-fee volume can create room.

09:15 How umbrella plans expanded participation without doctors realizing it.

10:10 Start with low-hanging fruit plans and lowest reimbursement fee schedules.

12:05 The reminder: about 50% of Americans don’t have dental insurance.

13:20 How many active patients a solo doctor with two hygienists actually needs.

15:15 Why the patient conversation should focus on quality of care, not fees.

17:05 What callers ask first—and how to answer the insurance question.

18:05 Predicting the future: hybrid models based on practice profile.

20:10 “Roleplay” reframed as upskilling the team.

23:05 Outsourcing insurance to specialists so teams do people work.

24:00 72 insurance code changes in 2025 and why that matters.

25:15 The biggest fear: upsetting the team, not the patients.

30:55 The transition checklist: due diligence, team prep, timelines, and letters.

33:00 Where to find Deborah and request the insurance letter template.

Guest Bio/Guest Resources

Debra Engelhardt-Nash has been in dentistry since 1985 as a consultant, trainer, author and speaker. She has presented workshops nationally and internationally for numerous associations and study clubs. She is a repeat presenter for organizations including Chicago Dental Society Midwinter Meeting, the Yankee Dental Meeting, The Swedish Academy of Cosmetic Dentistry, and the Greater New York Dental Meeting. Debra has also appeared on several podcasts and webinars and authored several articles for dental publications.

Debra served three terms as the President of the Academy of Dental Management Consultants who presented her their Lifetime Achievement Award as well as the Charles Kidd Meritorious Service Award. She is the Immediate Past President of the Academy for Private Practice Dentistry. She has been repeatedly recognized as a Leader in Consulting and Education by Dentistry Today and has been listed as top 25 Women in Dentistry. Debra is also the recipient of the Gordon Christensen Lecturer Recognition Award.

Guest Resources:

1. Deborah Engelhart Nash website: https://debraengelhardtnash.com/
2. Text: 704-904-3459

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